James Middleton, 32, recently told Tatler magazine that after his sister married Prince William in 2011, he was thrust into the limelight and struggled with fame. His battles with anxiety and depression — which he described as crippling — heightened, and he eventually “shut” out his family.

“Suddenly, and very publicly, I was being judged about whether I was a success or a failure,” he told the outlet in an article published on Monday.

“That does put pressure on you. Because in my mind, I’m doing this irrespective of my family and events that have happened.”

Middleton, who was 23 years old when Kate married the Duke of Cambridge, said he struggled with dyslexia at school. As he became more famous, his personalized gift business, Boomf, became under public scrutiny and he questioned his career abilities.

The entrepreneur said being famous wasn’t the reason he developed depression, and explained that he felt guilty for even struggling when he had so much.

“[Depression] is what keeps you in bed, while anxiety makes you feel guilty for being there,” he said.

“I thought, ‘What do I have to be depressed about?’ I’ve been so lucky with my upbringing, I had all the things I wanted. It’s not that I wanted more, but there was something that wasn’t always there… And the more I ignored it, the more it was taking over.”

In January, Middleton wrote an essay in the Daily Mail about his depression which he called a “cancer of the mind.” He also discussed his Attention Deficient Disorder (ADD), which he was diagnosed with in 2018.

He said that his depression, at times, was so debilitating he could hardly complete daily tasks.

“I barely functioned, stopped talking to my friends, went through the motions of living and working but achieved nothing at all,” he wrote.

“I came very close to shutting my company down. And still my heart was thudding as if it was straining to leap out of my body.”

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Middleton said that depression can be hard to understand in people who seemingly have so much, and live luxurious lives.

“I know I’m richly blessed and live a privileged life. But it did not make me immune to depression,” he wrote. “It is tricky to describe the condition. It is not merely sadness. It is an illness, a cancer of the mind.”

He said he was inspired to speak out after seeking treatment and realizing he has a platform to help others. Middleton credits cognitive behaviour therapy (CBT) and his dogs for helping him get through his hard time.

“The stigma attached to mental illness is lessening,” he wrote.

“If I could leave you with just one thought, it would be this: ‘It’s OK not to be OK.’ That is the mantra that gave me the strength to speak out. Having done so here, it feels as if a great weight has been lifted.”

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.